Provider Demographics
NPI:1760446470
Name:LONG, STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:LONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4870 BARRANCA PKWY
Mailing Address - Street 2:#260
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-1700
Mailing Address - Country:US
Mailing Address - Phone:949-551-0300
Mailing Address - Fax:949-551-0316
Practice Address - Street 1:4870 BARRANCA PKWY
Practice Address - Street 2:#260
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-1700
Practice Address - Country:US
Practice Address - Phone:949-551-0300
Practice Address - Fax:949-551-0316
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2011-10-04
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Provider Licenses
StateLicense IDTaxonomies
CAG55786207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E02780Medicare UPIN